A Medical Emergency, and the Growing Crisis at Immigration Detention Centers

Since May of this year, two immigrant detainees have died in custody at detention centers in Georgia, including one at Stewart Detention Center.

Photograph by Jonathan Wiggs / The Boston Globe via Getty

Stewart Detention Center, in Lumpkin, Georgia, is a hundred and forty
miles southwest of Atlanta. Past razor-wire fences and security
checkpoints, there’s a small, hot room where visitors who’ve received
permission can meet with detainees. A few weeks ago, I waited for two
hours—the daily count of the facility’s approximately sixteen hundred
detainees was under way—before sitting down in this room, with a
translator, to speak with Nelson Francisco Perdomo-Vaidez, a
thirty-four-year-old undocumented immigrant from Honduras, who had been
held at the center since mid-April.

Georgia has the fourth-largest number of immigrant
detainees in the country, with more than two thousand typically held on a daily
basis—nearly as many as Arizona. In May, Project
South, a Georgia-based nonprofit focussed on
immigrant advocacy, released a report, co-authored with Penn State Law’s Center for Immigrants’ Rights Clinic, detailing a twelve-month study of Stewart and another Georgia facility, Irwin County Detention Center. Both are run by private companies. The report
declared that conditions in both are in violation not only of
Immigration and Customs Enforcement’s own guidelines but of those
established, in 2012, by the office of the United Nations High Commissioner for
Refugees. The report recommended shutting down the two centers
immediately.

On the afternoon that I visited Perdomo-Vaidez, he had just seen a
doctor for only the second time since entering Stewart. (This second
appointment had been arranged by the Southern Poverty Law Center.)
Perdomo-Vaidez sustained a serious injury to his left arm prior to being
detained; while we spoke, he held the arm aloft, above his heart, to
prevent it from swelling and turning purple. He had begun to fear that
he would lose all or part of it. “Nobody tells me what might happen to
my arm or hand,” he told me. “They just offer more pills that don’t
help.” Heval Kelli, the Atlanta-based doctor who was allowed to
voluntarily assess him that day, concluded in his medical evaluation
that, without specialized orthopedic care and rigorous rehabilitation,
Perdomo-Vaidez could expect “further complications, including serious
infection, clots and the inability to use his left arm and hand.” (Bryan
Cox, a spokesman for ICE, denies that Perdomo-Vaidez requires orthopedic
treatment, and told me that the detained man has received “all
appropriate necessary medical treatment while in ICE custody.”)

Less than two weeks after Project South released its May report, two detainees died in custody at Georgia detention centers, one of them at Stewart. A Panamanian
detainee who was held in isolation for nearly three weeks committed suicide; days
later, an Indian detainee died, reportedly from congestive heart
failure.
A hundred and seventy-seven people have died in U.S. immigration
detention centers since October 1, 2003, according to the nonprofit
Community Initiatives for Visiting Immigrants in
Confinement. Six of those deaths have
occurred in Georgia. “Subpar medical care has contributed to nearly half
of the death cases we have analyzed nationally, and substandard medical
care has been evident in nearly ninety per cent of the cases,” Christina
Fialho, the co-executive director of the group, told me.

Stories abound. Ariel Prado, who has helped provide pro-bono legal
services to detainees at the South Texas Family Residential Center, the
largest immigration detention center in the U.S., recalls Vicks VapoRub
being used “as a kind of ‘cure-all,’ ” he told me. “The liquid version
was even poured into a child’s ear to ‘treat’ an earache.” The Project
South report describes a Chinese man with a broken leg who waited a
month for X-rays, and a Nigerian man with “lumps in his chest,” who told
a Project South interviewer that “blood had begun discharging from my
breast. When I requested medical care, sometimes no one would reply. I
was not given medical care until ICE later approved it. When I reached
out for medical help, I was placed in solitary.”

According to Azadeh Shahshahani, the legal director of Project South,
“nothing has changed for the better” in Georgia since the report’s
publication. Detainees continue to be denied daily health services and
timely follow-ups with a medical professional, as established by ICE’s
standards of practice. “Those standards seem to mean even less under the
Trump Administration than they did under Obama,” Shahshahani told me.

Perdomo-Vaidez left Honduras when he was twenty-three, he said. His
mother had died when he was fourteen, and he left the care of relatives
at fifteen. He got work as a bus driver in San Pedro Sula, the
second-biggest city in Honduras, but he couldn’t support his family.
Pandilleros were regularly extorting him. “They said they’d kill me
and burn my bus if I didn’t pay,” he told me. In 2006, with his wife
pregnant, he left Chiapas on a freight train, then took a bus to
Monterrey. A coyote helped him cross the border into Texas. An aunt
picked him up and drove him to Atlanta the next day.

He sat behind a plate-glass window as he spoke, wearing a beige prison
jumpsuit. He said that he’d lost twenty pounds in detention. He had a
scraggly goatee and a missing tooth. His left arm is heavily scarred
from surgeries that were done prior to his detention. In Atlanta and
surrounding areas, he worked in carpentry, for a subcontractor, for
eleven hours a day, earning four hundred to six hundred dollars per
week. This occupied him for most of the next decade. “I worked very
hard,” he said. He sent back all but a hundred dollars each week. For
years, he felt alone and secluded. There were a few close calls with
immigration, including an incident, in 2011, when he was pulled over
without car insurance. But he was let go.

Just over a year ago, he was working on a house in Athens, Georgia,
measuring trim atop a ladder twenty-four feet high, when the ladder
tipped. “I jumped off and made a little prayer,” Perdomo-Vaidez said. He
broke his left wrist, shattered his left radius, fractured a rib, and
punctured a lung. “They put me in a neck brace and brought me to a
hospital,” he said. “The doctor was surprised I survived the fall.”

Three days later, Perdomo-Vaidez received his first check for workers’
compensation. Insurance paid for transportation, an interpreter, a
therapist, a doctor. A case worker accompanied him to doctor’s visits.
After five surgeries over the following six months—there’s now a metal
plate with seven screws in his forearm and wrist—he began to improve,
taking oxycodone for the pain. On April 15th of this year, he and his
roommate, a U.S. citizen, got into an argument. Perdomo-Vaidez says the
man called him a “wetback.” He returned the insult. The man called the
cops, who arrested Perdomo-Vaidez for disorderly conduct. “When he put
me in handcuffs, he tightened them hard around my injured wrist. The
pain was so bad that, at the police station, I could barely lift my head
for the photo,” Perdomo-Vaidez told me.

He spent three days in jail before he was moved to an immigration
processing center. A week and a half later, he was driven two hours to
Stewart. On that final transport, a guard put toilet paper under his
cuffs. “But it didn’t do anything,” Perdomo-Vaidez told me, describing
the agony. Cox claims that Perdomo-Vaidez indicated no pain upon his
arrival at Stewart. Two weeks later, Perdomo-Vaidez told me, the pain
reached “a ten out of ten.” He would bury his head in a pillow to
scream. “My palm feels like pins and needles all the time,” he told me.
“Two of my fingers, too.” Often, the pain prevents him from sleeping.
The medical ward gives him acetaminophen and ibuprofen, he said. “At
first, I got four hundred milligrams of ibuprofen each day. That did
nothing. Now I get eight hundred milligrams of acetaminophen each day.
That does nothing, too. The nurses are afraid when they see my hand: the
dark purple color, cold to the touch. They ask me, ‘Why?’ I don’t know.”
On July 9th, according to Cox, Perdomo-Vaidez complained of
“intermittent wrist pain” and was subsequently diagnosed and treated for
a “wrist sprain.”

In late July, Perdomo-Vaidez said that he was finally taken to St.
Francis Hospital in nearby Columbus, Georgia. (Cox confirms that
Perdomo-Vaidez was “referred to a private medical facility for
additional treatment” at this time.) Perdomo-Vaidez said the doctor told
him that he needed to see a specialist. He was returned to Stewart.
Three days later, he said, he was told that a specialist was coming to
Stewart. Perdomo-Vaidez went to the medical area to wait. “A nurse told
me, ‘No, of course not. We don’t have specialists here. You leave for
those.’ ”

On Thursday, September 14th, Perdomo-Vaidez will go to court for an
immigration hearing. He’ll be represented by an attorney from the
Southern Poverty Law Center, who will ask for Perdomo-Vaidez’s immediate
release so that he may receive urgent medical care in the U.S. In the
meantime, according to Cox, Perdomo-Vaidez “has a scheduled consult with
a vascular surgeon for further evaluation.” But an order for his
deportation, the lawyer believes, is most likely. Back in Honduras,
Perdomo-Vaidez told me, his injury would continue to worsen, absent
first-world care, and likely result in amputation. “I’m not letting
myself hope anything,” he said.

Shahshahani, of Project South, told me, “My fear is that, with the
further explosion of the immigration detention system, which we’re
definitely going to see—unless Congress really takes a stronger step in
denying funding to the Trump Administration—I think that will result in
even worse conditions.”

Charles Bethea is a contributing writer for newyorker.com, and has written for The New Yorker since 2008.